Evidence map›Paper›PMID 38069666›Full record

Trial reportNeuro-oncology2024

Evaluating the heterogeneity of hippocampal avoidant whole brain radiotherapy treatment effect: A secondary analysis of NRG CC001.

Hua-Ren R Cherng, Kai Sun, Søren Bentzen, Terri S Armstrong, Vinai Gondi, Paul D Brown, Minesh Mehta, Mark V Mishra

Open access · greenAbstract readRandomized Controlled TrialClinical Trial, Phase III
In one paragraph

Trial report in Neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Hua-Ren R CherngDepartment of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland, USA.ORCID 0000-0002-4817-1007
Kai SunDivision of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA.
Søren BentzenDivision of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA.ORCID 0000-0002-7444-7564
Terri S ArmstrongNational Cancer Institute Center for Cancer Research, Bethesda, Maryland, USA.ORCID 0000-0002-2414-0492
Vinai GondiDepartment of Radiation Oncology, Northwestern Medicine Cancer Center and Proton Center, Warrenville, Illinois, USA.
Paul D BrownDepartment of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Minesh MehtaDepartment of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA.
Mark V MishraDepartment of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-2588-1575
University of Maryland, Baltimore · USBaptist Hospital of Miami · USMayo Clinic · USNational Cancer Institute · USNorthwestern Medicine · US

Funding

UNIVERSITY OF MARYLAND GREENEBAUM CANCER CENTERSUPPORT GRANTP30CA134274 · NCI · UNIVERSITY OF MARYLAND BALTIMORE · PI FEYRUZ VIRGILIA RASSOOL · 2008 to 2026
$51.0M
Natural History and Specimen Banking for Patients with CNS TumorsZIABC011768 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI ARMSTRONG, TERRI S. · 2017 to 2024
$6.7M
NCI NIH HHS P30 CA134274
6 · The paper itself

Abstract

backgroundHippocampal avoidant whole brain radiotherapy (HA-WBRT) is the standard of care for patients needing WBRT for brain metastases. This study, using existing data from NRG Oncology CC001 including baseline tumor characteristics and patient-reported MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT) scores, sought to identify subgroups of patients that demonstrate differential neuroprotective treatment response to HA-WBRT.

methodsAn exploratory analysis of NRG CC001, a phase 3 trial in which 518 patients were randomly assigned to WBRT plus memantine or HA-WBRT plus memantine, was performed. Rates of neurocognitive function failure (NCFF) were estimated between subgroups and stratified by arm. Covariate and subgroup interaction with differential treatment response were calculated.

resultsThe benefit of HA-WBRT on decreasing NCFF was seen in patients living ≥ 4 months (HR 0.75, 95% CI: 0.58-0.97, P = .03), whereas patients living < 4 months derived no significant neurocognitive benefit. A significant association between baseline MDASI-BT cognitive factor and treatment response (interaction P = .03) was identified. Patients with lower MDASI-BT scores (less patient-reported cognitive impairment) derived significantly greater benefit (HR = 0.64, 95% CI: 0.48-0.85, P = .002) compared to those with highest MDASI-BT scores (HR = 1.24, 95% CI: 0.76-2.04, P = .39). Tumor histology also had a significant interaction (P = .01) with treatment response. Primary lung histology patients derived cognitive failure risk reduction (HR = 0.58, 95% CI: 0.43-0.77, P = .0007) from HA-WBRT, in contrast to nonlung primary histology patients (HR = 1.15, 95% CI: 0.78-1.50, P = .48).

conclusionsDifferential neuroprotective response to HA-WBRT was identified in this analysis. Patients surviving ≥ 4 months derived benefit from HA-WBRT. There is evidence of heterogeneity of treatment effect for patients with less severe patient-reported cognitive impairment at baseline and those with primary lung histology.

Indexed as

Brain NeoplasmsCranial IrradiationHippocampusAdultAgedFemaleFollow-Up StudiesHumansMaleMemantineMiddle AgedPrognosisMemantinebrain metastasesheterogeneity of treatment effecthippocampal avoidance whole brain radiotherapyneurocognitive toxicity

Identifiers

PMID38069666
PMCPMC11066939
OpenAlexW4389507153

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.